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March 11, 2014

She had spent the last three months battling a formidable brain tumor, which was causing her to slowly lose control of her body. She didn't suffer; in fact, I was amazed at how readily she adapted to her new-found constraints, happy to just be with those she loved. We could learn a lot from dogs in that sense.

But today she was finally able let go. And so was I.

I was with her at the end, and when she slipped away, all I could think of was this poem. It gives me some sense of peace amidst the sadness.

She Let Go

She let go. Without a thought or a word, she let go.

She let go of the fear. She let go of the judgments. She let go of the confluence of opinions swarming around her head. She let go of the committee of indecision within her. She let go of all the 'right' reasons. Wholly and completely, without hesitation or worry, she just let go.

She didn't ask anyone for advice. She didn't read a book on how to let go... She didn't search the scriptures. She just let go. She let go of all of the memories that held her back. She let go of all of the anxiety that kept her from moving forward. She let go of the planning and all of the calculations about how to do it just right.

She didn't promise to let go. She didn't journal about it. She didn't write the projected date in her Day-Timer. She made no public announcement and put no ad in the paper. She didn't check the weather report or read her daily horoscope. She just let go.

She didn't analyze whether she should let go. She didn't call her friends to discuss the matter. She didn't do a five-step Spiritual Mind Treatment. She didn't call the prayer line. She didn't utter one word. She just let go.

No one was around when it happened. There was no applause or congratulations. No one thanked her or praised her. No one noticed a thing. Like a leaf falling from a tree, she just let go.

There was no effort. There was no struggle. It wasn't good and it wasn't bad. It was what it was, and it is just that.

In the space of letting go, she let it all be. A small smile came over her face. A light breeze blew through her. And the sun and the moon shone forevermore.

January 05, 2014

Early in December I noticed that her back legs were a bit wobbly. She tripped on the stairs a couple of times, had trouble making the leap onto the couch, and exhibited a slightly drunken gate while out on walks. Her dog walker noticed the same, and left me a note about it.

I assumed that her knees were acting up again - she has had two separate surgeries in the past to correct a luxating patella on each of her back legs - and given how rambunctious she can be I'm always wary of her knees.

So I took her in to South Bay Veterinary Group (where she's gone her whole life, and has had wonderful treatment), and they detected some arthritis in the knees but nothing else. They put her on Deramaxx (an anti-inflammatory) and sent us home.

About a week later, Lulu stopped eating. It isn't unusual for her to skip a meal here and there, and we've always marveled at the fact that she's a rather finicky eater. Have you ever known a dog to turn her nose up at filet mignon mixed in with her kibble? That's my Lulu. But she'll ususally just skip dinner one night, maybe two, and then hunger gets the best of her and she goes back to eating like normal. So it wasn't until the third night of her skipping dinner that I really started to worry. She wouldn't eat her dog food, but I did get her to eat a scrambled egg (one of her favorite dishes!). That was Sunday, December 15th.

On Monday, December 16th, things really took a turn for the worse. I was getting ready for work when I heard her choking in the next room. I ran out in time to see her vomit, keel over on her side, and lose control of her bladder. It was horrible. I quickly cleaned her up, wrapped her in a towel, and placed her in her bed while I threw on some clothes.

By the time I got her over to South Bay, about 3 miles from my house, she was almost back to normal. Besides the stress that typically accompanies a vet visit and her aforementioned weak back end, she seemed ok. And all of her vitals were fine - temperature, heart rate, blood pressure - but given my description of what happened, her doctor suggested we see a neurologist. All of the specialists at MSPCA-Angell Memorial Hospital in Boston were booked for 2 weeks, so they recommended that I take her to the Massachusetts Veterinary Referral Hospital up in Woburn (12 miles north of Boston). I hadn't heard of it before, but they had an opening at 11am that morning (and I've subsequently had 3 different people tell me that they've taken their dogs there and had wonderful care).

Again I put Lulu in the car and we went up to Woburn where I met with the Neurologist for about an hour, explaining everything I'd seen and sharing some videos I'd taken of her gait. And again, all of her vitals seemed fine. She didn't appear to have any pain along the spine, which would indicate some sort of back or disc problem. They asked me to leave her so that they could run some tests, including an MRI.

Four hours later I got the call explaining what was going on: Lulu's MRI revealed a brain tumor - a meningioma - just behind her right eye. You can see it clearly in the scans below:

They think it's been growing for 6 months or more, based on its size. And while this type of tumor won't metasticize (spread to other body parts), it will continue to grow and put pressure on the brain. This is why she was losing control of her legs.

We now have her on Prednisone (a steroid to reduce swelling in the brain) and Pepcid (an antacid to prevent ulcer) twice a day, which seems to have stabilized her. We also have an emergency pack of Valium should she have seizures...which we will hopefully never have to use [on her. Some days I'd like to take it!]. While her back legs are still weak, and she's experiencing increased thirst (drinking), urination, panting, and appetite due to the medication, she's active and eating again. Aside from the occasional trembling, she seems happy and comfortable.

But Prednisone isn't a long term solution, as it can result in muscle atrophy, liver disease, bone weakening, and/or increased potential for stroke over time. The vet said she could probably stay on it for 6-12 months before other side effects would force us to discontinue it.

There is another treatment option: surgery to remove as much of the tumor as possible, and radiation to slow its return. But I'm not inclined to put her through this. Here's why:

The surgery is risky and has no guarantees. She could die on the table or wake up worse off than she was going into it. Also, it is impossible to get a clean margin around the tumor without damaging the surrounding brain tissue, so the objective would be to de-bulk the tumor, not entirely remove it. Which means it will grow back at some point.

The radiation is 4 weeks of daily (M-F) treatments. Knowing how much she dreads vet visits, I can't imagine how she'd handle going in there every day and being sedated. She wouldn't understand why we're doing this to her, and the stress would probably kill her.

She turned 10 last October (which, sadly, is about the expected lifespan for her breed). Seeing how hard it was for her to recover from the anesthesia she received pre-MRI, I'm concerned that it would simply be too much for her at this age.

So for now, we are going to continue with the Prednisone and take things one day at a time. I learned to do that with my own health, and now I'll just have to do it with hers.

December 25, 2013

December 23, 2013

On November 16th I wrote the below essay for my writing class; the assignment was "Write about leaving (a person or a place)."

I didn't know it at the time, but the last line would prove to be alarmingly prophetic. You see, exactly one month later, on December 16th, my French bulldog Lulu was diagnosed with a brain tumor (meningioma). I'll save the details for another day, but wanted to share my essay, here:

Leaving

November 16, 2013

When I enter the front hallway I hear it again: a low, guttural baying coming from the apartment upstairs. My apartment, where my French bulldog, Lulu, anxiously awaits my return. It’s a distressing sound, one that evokes images of agony or pain. But I know she is safe in her little fleece bed, surrounded by stuffed animals and chew sticks. She just has trouble with me leaving.

It begins every morning when I get ready for work. Lulu stays curled up in bed, a watchful eye on the closed bathroom door. She’d love to sleep in, but can’t fully relax knowing that my departure is imminent. It takes about fifteen minutes before anxiety gets the best of her and she head-butts her way into the bathroom, eyes wide, stealing a peek around the shower curtain to make sure I’m still there. She then sits quietly on the bath mat with a frown on her face, contemplating how she’ll survive the next four hours alone, before the dog walker arrives.

They say that dogs can’t differentiate between five minutes and five hours, and I hope that’s true.But it doesn’t lessen the guilt I feel every time I prepare to go and she stares up at me with those unwavering brown eyes and furrowed brow as if to say, “You’re leaving again?!” Imagine the toll this daily stress must take on her little body, now ten years old and graying on the fringe. Ten years. That’s how long we’ve been playing this game. “Mind the house,” I say, and hope for the best.

What did I do to make her feel this way? Why can’t she just acknowledge how good she has it, with a comfortable home, warm bed, and plenty of food and water? “She is just a dog,” I tell myself, unconvincingly, as I feel that familiar twinge of unease in my stomach.

But every time I return, and her wiggly little body comes bouncing and snorting towards the door, she reminds me that she is not just a dog. She is my biggest fan, greeting me with one of many assorted squeak toys in her mouth – a gurgling swordfish, a gobbling turkey, or a croaking frog – which she drops at my feet before looking up at me with a toothy smile. She is panting and jumping and simply amazed that I have returned. It’s a remarkable feeling, really.

Lulu has been with me through four jobs, three apartments, two boyfriends, and one cancer diagnosis. She has been the one constant throughout a decade of challenges, changes and celebrations. She is my shadow, following me from room to room in earnest. She is my jester, bringing a smile to my face with her silly antics. She is my confidante, quietly listening to my varied rants and raves without judgment. And she is my steady companion, happy to be with me and do nothing.

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6) I finally finished reading Wild by Cheryl Strayed, and I really enjoyed it. Now I'm itching for an adventure. And want to write a memoir.